Institute of Health and Care Sciences, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden; Center for Person-Centered Care, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
Epilepsia. 2014 Jun;55(6):878-85. doi: 10.1111/epi.12616. Epub 2014 Apr 4.
To evaluate health-related quality of life (HRQOL), mood, and patient satisfaction in epilepsy surgery candidates before and 2 years after epilepsy surgery or presurgical investigation.
In this prospective study of 141 patients, 96 underwent surgery and 45 did not. Questionnaires at baseline and at 2-year follow-up included the generic 36-item Short Form Health Survey (SF-36), the Hospital Anxiety and Depression scale (HAD), and operated patients answered patient satisfaction questions. SF-36 scores were compared with scores from a matched sample from the Swedish norm population. Numbers were calculated of patients achieving a minimum important change (MIC) in the SF-36 Physical Composite Summary (PCS) and Mental Composite Summary (MCS).
At baseline, patients had significantly lower values than the norm on all SF-36 domains. At follow-up, operated patients were divided into seizure-free (International League Against Epilepsy [ILAE] class 1 and 2, n = 53) or with continued seizures (n = 43). No differences in baseline HAD or SF-36 values were found between these groups. Seizure-free patients reached the same levels as the norm in all SF-36 domains except Social Function. Operated patients with continued seizures and nonoperated patients had unchanged scores. Fifty-one percent of seizure-free patients had an improvement reaching MIC for PCS and 45% for MCS. Corresponding results for patients with continued seizures were 28% in PCS and 28% in MCS, for nonoperated 33% in PCS and 29% in MCS. HAD anxiety scores improved significantly in only the seizure-free patients. Of all operated patients, 80% were satisfied with having had surgery and 86% considered that they had benefited, whereas 20% thought that surgery caused some harm.
In patients who were seizure-free after epilepsy surgery HRQOL normalized and anxiety decreased. Operated patients overwhelmingly considered epilepsy surgery to be beneficial. Nonetheless, only about half of the seizure-free patients achieved important HRQOL improvements, suggesting that seizure freedom does not in and of itself guarantee improved patient well-being. A PowerPoint slide summarizing this article is available for download in the Supporting Information section here.
评估癫痫手术候选者在手术前和手术后 2 年的健康相关生活质量（HRQOL）、情绪和患者满意度。
在这项对 141 名患者的前瞻性研究中，96 名患者接受了手术，45 名患者未接受手术。基线和 2 年随访时的问卷包括通用 36 项简短健康调查（SF-36）、医院焦虑和抑郁量表（HAD），以及接受手术的患者回答患者满意度问题。将 SF-36 评分与瑞典常模人群中的评分进行比较。计算 SF-36 生理综合摘要（PCS）和心理综合摘要（MCS）中达到最小重要变化（MIC）的患者人数。
在基线时，所有患者的 SF-36 各领域得分均明显低于常模。在随访时，手术患者分为无癫痫发作（国际抗癫痫联盟[ILAE] 1 级和 2 级，n=53）或持续癫痫发作（n=43）。这两组之间在基线 HAD 或 SF-36 值方面没有差异。无癫痫发作的患者在除社会功能外的所有 SF-36 领域都达到了常模水平。持续癫痫发作的手术患者和未手术患者的评分保持不变。51%的无癫痫发作患者的 PCS 和 MCS 达到 MIC 的改善。持续癫痫发作患者的相应结果分别为 PCS 的 28%和 MCS 的 28%，未手术患者的相应结果分别为 PCS 的 33%和 MCS 的 29%。只有无癫痫发作的患者 HAD 焦虑评分显著改善。所有手术患者中，80%对手术感到满意，86%认为他们从中受益，而 20%认为手术造成了一些伤害。
在癫痫手术后无癫痫发作的患者中，HRQOL 正常化，焦虑减轻。手术患者绝大多数认为癫痫手术有益。尽管如此，只有约一半的无癫痫发作患者实现了重要的 HRQOL 改善，这表明癫痫无发作本身并不能保证改善患者的幸福感。本文的幻灯片摘要可在支持信息部分下载。
